The Impact of SARS-CoV-2 Pandemic on the New Cases of T1DM in Children. A Single-Centre Cohort Study.

Anca Andreea Boboc,Felicia Galoș,Mara Ioana Ieșanu,Marcela Daniela Ionescu,Carmen Nicoleta Novac,Elena Camelia Berghea,Mihaela Bălgrădean,Maria Teodora Ilie

doi:10.3390/jpm11060551

Abstract

Type 1 diabetes mellitus (T1DM) represents one of the most frequent chronic illnesses affecting children. The early diagnosis of this disease is crucial, as it plays a key role in preventing the development of a life-threatening acute complication: diabetic ketoacidosis. The etiopathogenetic role of viral infections has long been suggested and emerging data are pointing towards a complex bidirectional relationship between diabetes and COVID-19. The aim of this study is to assess the impact of the COVID-19 pandemic on the incidence and severity of new T1DM cases in children in Romania. We analyzed the differences between a group of 312 patients diagnosed with T1DM in the period 2003–2019 and a group of 147 children diagnosed during the pandemic. The data were investigated using statistical analysis of a series of relevant variables. The total number of newly diagnosed T1DM increased by 30.08% in the period March 2020–February 2021 compared to the previous years. The patients in the pandemic group had a higher mean age at the onset of T1DM, were less frequently living in an urban area, and presented a higher mean value of HbA1c. Diabetic ketoacidosis at the onset of T1DM was 67.40% more frequent, and a higher percentage of these patients presented with a severe form. The duration of T1DM symptoms did not differ significantly between the two groups. A number of 8 patients associated SARS-CoV-2 infection at the time of T1DM diagnosis.

Highlights

In the first 2 months of the pandemic, the number of new Type 1 diabetes mellitus (T1DM) cases was lower than that reported in the same period of the previous year, the same difference being reported in another study which analyzed the number of children diagnosed with T1DM
The patients that presented during the pandemic had a lower mean age, higher values of HbA1c, and were living more frequently in a rural area compared to the previous years
The number of diabetic ketoacidosis presentations showed an increase during the pandemic, patients diagnosed after March 2020 having a significantly higher risk of developing DKA, when adjusting for other predictors

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Type 1 diabetes mellitus (T1DM) is a metabolic disease characterized by the autoimmunemediated destruction of the pancreatic β-cells that leads to a deficit in the production of insulin with various repercussions on the intermediary metabolism. T1DM represents one of the most frequent chronic illnesses in pediatric population and has shown a continuously increasing incidence over the last decades [1]. Urban 261(83.65) 91 (61.90) (45.51) Rural 51 (16.35) 56 (38.10)

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